HL7 and FHIR in Australia: Building Practical Healthcare Interoperability
Australia is accelerating its use of FHIR APIs, national standards and secure digital health information exchange.
The Australian Digital Health Agency’s 2025–26 progress report confirms completion of Action 2.12, API Information Exchange, supporting HL7 FHIR, OAuth and OpenID Connect for secure API-based exchange.[1]
This is an important evolution, but it does not mean Australia’s established HL7 infrastructure is being replaced.
FHIR Builds on HL7
FHIR, Fast Healthcare Interoperability Resources, is an HL7 standard developed using lessons from HL7 v2, HL7 v3 and CDA. HL7 International specifically notes that FHIR can operate independently and in partnership with existing widely used standards.[2]
That matters in Australia. The National Healthcare Interoperability Plan identifies HL7 v2 as the most commonly used information exchange specification across Australian health sectors, while also supporting increased adoption of FHIR APIs.[3]
The practical path forward is therefore not simply HL7 versus FHIR. It is enabling the two to coexist.
The US Experience Supports Coexistence
The United States is further advanced in regulatory adoption of FHIR, but existing HL7 infrastructure remains heavily used.
US government data published in 2024 found that more than 80% of surveyed health information exchange organisations routinely or sometimes exchanged HL7 v2 messages, while around one-fifth reported exchanging information using FHIR APIs.[4]
FHIR is expanding interoperability rather than instantly replacing established clinical exchange.
Interoperability is More Than an API
FHIR provides an important technical foundation, but successful health information exchange still depends on:
- Compliance with recognised standards and conformance requirements
- Accurate patient and provider identification
- Consistent terminology and data structures
- Secure authentication and authorisation
- Reliable routing, delivery and acknowledgements
- Auditability and traceability
- Integration with existing clinical workflows
- Translation between established and emerging standards
Australia’s own Interoperability Plan states that interoperability is made possible through the implementation of standards and places strong emphasis on national conformance, identity and information-sharing requirements.[3]
Connecting HL7 and FHIR
Medical-Objects has more than two decades of experience in healthcare interoperability and is a long-standing HL7 member.
As an Australian-owned company, Medical-Objects operates Australia’s largest Australian-owned clinical messaging network, now connecting more than 132,500 healthcare professionals.[5]
Our architecture is evolving to support HL7 v2 ↔ FHIR interoperability, helping existing clinical systems participate in emerging FHIR-based eRequests, APIs and digital health services while continuing to support proven real-time clinical workflows.
Australia does not need to discard what already works to embrace FHIR.
The opportunity is to connect today’s clinical systems with Australia’s FHIR-enabled future.
References
1. Australian Digital Health Agency, Connecting Australian Healthcare: National Healthcare Interoperability Plan 2023–2028, Annual Progress Report July 2025–June 2026, Action 2.12. ↗
2. HL7 International, FHIR Overview: Relationship with existing HL7 standards. ↗
3. Australian Digital Health Agency, National Healthcare Interoperability Plan 2023–2028, Standards and Conformance sections. ↗
4. US Assistant Secretary for Technology Policy / Office of the National Coordinator for Health IT, Standards Adoption Among Health Information Exchange Organizations, Data Brief No. 75, October 2024. ↗
5. Medical-Objects, About Us / Provider Network, current network information. ↗